Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni

Shona Wilson; Birgitte J Vennervald; Hilda Kadzo; Edmund Ireri; Clifford Amaganga; Mark Booth; H. Curtis Kariuki; Joseph K. Mwatha; Gachuhi Kimani; John H. Ouma; Eric Muchiri; David W. Dunne

doi:10.1016/j.trstmh.2009.08.006

Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni

Shona Wilson, Birgitte J Vennervald, Hilda Kadzo, Edmund Ireri, Clifford Amaganga, Mark Booth, H. Curtis Kariuki, Joseph K. Mwatha, Gachuhi Kimani, John H. Ouma, Eric Muchiri, David W. Dunne

16 Citationer (Scopus)

Abstract

Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen being chronically enlarged and of a firm consistency. Where co-endemic, the two parasites are thought to synergistically exacerbate hepatosplenomegaly. Here, two potential health consequences, i.e. dilation of the portal vein (indicative of increased portal pressure) and stunting of growth, were investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with dilation. Dilation of the portal vein was exacerbated by S. mansoni infection in an intensity-dependent manner. The prevalence of growth stunting was not associated with either relative exposure rates to malarial infection or with S. mansoni infection status but was significantly associated with hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.

Originalsprog	Engelsk
Tidsskrift	Transactions of the Royal Society of Tropical Medicine and Hygiene
Vol/bind	104
Udgave nummer	2
Sider (fra-til)	110-116
Antal sider	7
ISSN	0035-9203
DOI	https://doi.org/10.1016/j.trstmh.2009.08.006
Status	Udgivet - feb. 2010

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10.1016/j.trstmh.2009.08.006

Citationsformater

Wilson, S., Vennervald, B. J., Kadzo, H., Ireri, E., Amaganga, C., Booth, M., Kariuki, H. C., Mwatha, J. K., Kimani, G., Ouma, J. H., Muchiri, E., & Dunne, D. W. (2010). Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni. Transactions of the Royal Society of Tropical Medicine and Hygiene, 104(2), 110-116. https://doi.org/10.1016/j.trstmh.2009.08.006

Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni. / Wilson, Shona; Vennervald, Birgitte J; Kadzo, Hilda et al.

I: Transactions of the Royal Society of Tropical Medicine and Hygiene, Bind 104, Nr. 2, 02.2010, s. 110-116.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Wilson, S, Vennervald, BJ, Kadzo, H, Ireri, E, Amaganga, C, Booth, M, Kariuki, HC, Mwatha, JK, Kimani, G, Ouma, JH, Muchiri, E & Dunne, DW 2010, 'Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni', Transactions of the Royal Society of Tropical Medicine and Hygiene, bind 104, nr. 2, s. 110-116. https://doi.org/10.1016/j.trstmh.2009.08.006

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title = "Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni",

abstract = "Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen being chronically enlarged and of a firm consistency. Where co-endemic, the two parasites are thought to synergistically exacerbate hepatosplenomegaly. Here, two potential health consequences, i.e. dilation of the portal vein (indicative of increased portal pressure) and stunting of growth, were investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with dilation. Dilation of the portal vein was exacerbated by S. mansoni infection in an intensity-dependent manner. The prevalence of growth stunting was not associated with either relative exposure rates to malarial infection or with S. mansoni infection status but was significantly associated with hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.",

keywords = "Adolescent, Animals, Body Height, Child, Child, Preschool, Cohort Studies, Female, Growth Disorders, Hepatomegaly, Humans, Kenya, Malaria, Falciparum, Male, Schistosomiasis mansoni, Splenomegaly",

author = "Shona Wilson and Vennervald, {Birgitte J} and Hilda Kadzo and Edmund Ireri and Clifford Amaganga and Mark Booth and Kariuki, {H. Curtis} and Mwatha, {Joseph K.} and Gachuhi Kimani and Ouma, {John H.} and Eric Muchiri and Dunne, {David W.}",

year = "2010",

month = feb,

doi = "10.1016/j.trstmh.2009.08.006",

language = "English",

volume = "104",

pages = "110--116",

journal = "Transactions of the Royal Society of Tropical Medicine and Hygiene",

issn = "0035-9203",

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T1 - Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni

AU - Wilson, Shona

AU - Vennervald, Birgitte J

AU - Kadzo, Hilda

AU - Ireri, Edmund

AU - Amaganga, Clifford

AU - Booth, Mark

AU - Kariuki, H. Curtis

AU - Mwatha, Joseph K.

AU - Kimani, Gachuhi

AU - Ouma, John H.

AU - Muchiri, Eric

AU - Dunne, David W.

PY - 2010/2

Y1 - 2010/2

N2 - Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen being chronically enlarged and of a firm consistency. Where co-endemic, the two parasites are thought to synergistically exacerbate hepatosplenomegaly. Here, two potential health consequences, i.e. dilation of the portal vein (indicative of increased portal pressure) and stunting of growth, were investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with dilation. Dilation of the portal vein was exacerbated by S. mansoni infection in an intensity-dependent manner. The prevalence of growth stunting was not associated with either relative exposure rates to malarial infection or with S. mansoni infection status but was significantly associated with hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.

AB - Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen being chronically enlarged and of a firm consistency. Where co-endemic, the two parasites are thought to synergistically exacerbate hepatosplenomegaly. Here, two potential health consequences, i.e. dilation of the portal vein (indicative of increased portal pressure) and stunting of growth, were investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with dilation. Dilation of the portal vein was exacerbated by S. mansoni infection in an intensity-dependent manner. The prevalence of growth stunting was not associated with either relative exposure rates to malarial infection or with S. mansoni infection status but was significantly associated with hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.

KW - Adolescent

KW - Animals

KW - Body Height

KW - Child

KW - Child, Preschool

KW - Cohort Studies

KW - Female

KW - Growth Disorders

KW - Hepatomegaly

KW - Humans

KW - Kenya

KW - Malaria, Falciparum

KW - Male

KW - Schistosomiasis mansoni

KW - Splenomegaly

U2 - 10.1016/j.trstmh.2009.08.006

DO - 10.1016/j.trstmh.2009.08.006

M3 - Journal article

C2 - 19818465

SN - 0035-9203

VL - 104

SP - 110

EP - 116

JO - Transactions of the Royal Society of Tropical Medicine and Hygiene

JF - Transactions of the Royal Society of Tropical Medicine and Hygiene

IS - 2

ER -

Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni

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